How can I treat recurrent pityriasis versicolor on my face?

Question

Hello doctor,

I have a skin condition called pityriasis versicolor, which is currently on my face but has not spread across the entire face yet. I have been dealing with recurrent episodes for about five years.

The last time it became widespread, I was treated with oral Ketoconazole tablets. This time, I have been prescribed oral Terbinafine along with a cream that contains Terbinafine and a steroid (Terbibact).

From my experience, oral Terbinafine does not seem effective for my condition. Previously, my flare-up was triggered by a cream containing a steroid. My parents are also suggesting using an antiseptic and scrubbing my face, but I feel that may not be appropriate.

So what should I do?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you so much for your query at Icliniq and for sharing the detailed history.

Yes, oral Terbinafine is not recommended by any international guidelines for pityriasis versicolor, and steroid creams cause its flare, as it is caused by the body’s own natural flora fungus called Malassezia furfur.

Normally, versicolor is most common on the upper body, like the shoulders, chest, and back, and very little on the face and lower limbs. I would appreciate it if you could share a picture of the affected area so that I can confirm the diagnosis as well.

In your case, you are having a chronic relapse. I am going to guide you on what will help to clear the versicolor and is recommended internationally for the treatment of versicolor.

Take Itraconazole capsule 100 milligrams twice a day for just seven days; it will clear your infection. This is the only antifungal in oral form that is recommended for versicolor.

For topical treatment, continue using Terbinafine cream morning and night on the affected area. Use Ketoconazole shampoo as a face wash, apply for three to four minutes, and then wash daily once.

It will clear the infection in three weeks, and the pigmentation, whether hypo (white patches) or hyper (dark patches), takes time to resolve after a few weeks of clearance of infection, so do not worry about that.

You just need to use the topical medication for three weeks and the oral medication for just five days.

Avoid sharing towels and clothes with other members of the family, as they can spread from one to another. Avoid using antiseptics or scrubbers on the face, as they will further damage your condition.

I hope this helped with your query. Please give your valuable feedback for better patient care.

Thanks and regards.

How can I treat recurrent pityriasis versicolor on my face?

Dealing with recurrent pityriasis versicolor?